5th International Conference on Heart and Cardiovascular Diseases

Shakhnoza Samidjanova is a medical professional and researcher affiliated with the Republican Specialized Scientific-Practical Medical Center of Cardiology in Uzbekistan. Her research interests include clinical cardiology, ischemic heart disease, metabolic disorders, and the evaluation of biochemical markers associated with cardiovascular health. Her research, titled “Characteristics of Biochemical Parameters in Patients with Ischemic Heart Disease and Varying Metabolic Profiles,” focuses on examining biochemical variations among patients with ischemic heart disease and different metabolic profiles. Her work highlights the importance of assessing metabolic indicators, including glucose and lipid parameters, to better understand cardiovascular risk factors and disease progression. Through this research, she contributes to the broader understanding of cardiometabolic interactions and the potential role of biochemical assessment in supporting individualized patient management and improved cardiovascular outcomes.

Aim: To evaluate clinical and instrumental parameters in patients with ischemic heart disease (IHD) based on body mass index (BMI)

Materials and methods: This was a retrospective study. Medical records were analyzed for 98 patients with ischemic heart disease (IHD) who had indications for coronary artery bypass grafting (CABG) and sought care at the Republican Specialized Scientific-Practical Center of Cardiology between January and June 2025. Based on BMI, patients were divided into three groups: Group I (n=14) – normal BMI (23.6±1.3 kg/m²); Group II (n=46) – excess BMI (27±1.3 kg/m²); and Group III (n=38) – BMI >30 kg/m² (33.5±3.1 kg/m²). Clinical, anamnestic, and instrumental parameters were analyzed. Inclusion criteria: patients with ischemic heart disease indicated for coronary artery bypass grafting (CABG). Exclusion criteria: acute myocardial infarction, valvular heart disease, diabetes mellitus, severe renal or hepatic insufficiency, malignancies, and systemic diseases. Glomerular filtration rate (GFR) was calculated for all patients using the CKD-EPI formula. The albumin-to-creatinine ratio (ACR) was assessed in a single urine sample using an enzyme immunoassay analyzer. Plasma NT-proBNP levels were determined using Abbott reagents on an automated iArchitect 2000sr analyzer (Abbott, Abbott Park, IL). Insulin levels and the lipid profile were determined using an enzyme immunoassay analyzer.

Study results: The ages of the patient groups being compared were comparable, with a slight predominance in the second group (65.8 years versus 63.6 and 64.5 years in groups 1 and 3, respectively; p > 0.05). Analysis of clinical parameters revealed significant differences between the groups regarding systolic and diastolic blood pressure (SBP and DBP). SBP and DBP levels were significantly higher in the group of patients with a BMI > 30 kg/m² (132.6 mmHg and 82.3 mmHg) compared to the group with a normal BMI (121.1 mmHg and 76.9 mmHg, respectively; p = 0.03). The group with a BMI > 30 kg/m² was characterized by hyperfiltration; specifically, the glomerular filtration rate (GFR) was 101.9 ml/min, compared to 72.3 ml/min in the normal BMI group (p = 0.02) and 74.5 ml/min in the group with excess BMI (p = 0.0006). The AKO level was significantly higher in the obese group, measuring 78 mg/L compared to 31.3 mg/L in the group with excess BMI (p=0.03) and 23.1 mg/L in the group with normal BMI (p=0.001). Significant differences were also found regarding NT-proBNP levels, which were significantly lower in patients with a BMI >30 kg/m² (524.2 pg/mL) compared to those with normal BMI (2409.8 pg/mL; p=0.02). Analysis of insulin levels revealed significantly higher values in the obese group compared to the normal BMI group (12.1 μU/mL vs. 7.76; p=0.02). Similarly, the HOMA index was higher, measuring 6.22 compared to 4.03 in the normal BMI group (p=0.0001) and 4.66 in the group with excess BMI (p=0.0001). The groups differed in their levels of atherogenic lipids and high-density lipoprotein cholesterol (HDL-C), with significant differences observed between the excess BMI and normal BMI groups; specifically, LDL-C levels were 159.2 mg/dL in the excess BMI group versus 85.6 mg/dL (p=0.04). HDL-C levels were 42.1 mg/dL in the group with normal BMI versus 37 mg/dL in the group with excess BMI (p=0.04). In the group of patients with obesity, these values were 117.4 mg/dL and 41.0 mg/dL, respectively.

Conclusion: The vast majority of patients with ischemic heart disease and multivessel coronary artery disease have excess BMI (47%) or obesity (39%). Obesity was significantly associated with elevated systolic and diastolic blood pressure levels. Patients with obesity exhibited signs of intraglomerular hypertension, evidenced by hyperfiltration and a high albumin-to-creatinine ratio. Obese patients demonstrated high levels of insulin resistance and significantly worse lipid profiles, further confirming the progression of cardiorenal-metabolic syndrome.